Eugenix 3514 grafts (720 on the temples) May 2022 Dr Priyadarshini Das

[Rafael Manelli]

15 minutes ago, GeneralNorwood said:

 

So what if the growh was good, when  there was no solid plan - Dr Bisanga

Bisanga is right I’m afraid. I think Berber was just trying to encourage you to look on the bright side. But you must stick up for your interests.

[GeneralNorwood]

10 minutes ago, Rafael Manelli said:

Bisanga is right I’m afraid. I think Berber was just trying to encourage you to look on the bright side. But you must stick up for your interests.

I tried to look at the bright side, you know. Many users supported me here that after 2HT it will be home run etc. 

But consultation with Dr Bisanga opened my eyes for some things. He said that because of poor planning this became very hard case. Now we have huge area to cover and limited donor. He was very convincing, because he used some device too look closely for grafts/cm2 in few areas in donor and told that it's 65 graft/cm2, then he did the measurements of the safe zone and told that i have around 3200 grafts left. So his opinion wasn't based on empty words, but on simple math. 

Edited March 23, 2023 by GeneralNorwood

[Rafael Manelli]

4 minutes ago, GeneralNorwood said:

I tried to look at the bright side, you know. Many users supported me here that after 2HT it will be home run etc. 

But consultation with Dr Bisanga opened my eyes for some things. He said that because of poor planning this became very hard case. Now we have huge area to cover and limited donor. He was very convincing, because he used some device too look closely for grafts/cm2 in donor, then he did the measurements of the safe zone and told that i have around 3200 grafts left. So his opinion wasn't based on empty words, but on simple math. 

Maybe Sethi will use a different math and discover 5000 extra grafts somehow!

[GeneralNorwood]

3 minutes ago, Rafael Manelli said:

Maybe Sethi will use a different math and discover 5000 extra grafts somehow!

Somebody at the beginning of this topic said that it is ballsy restoration for someone with my level of hairloss. Maybe it was prophecy 😆

Edited March 23, 2023 by GeneralNorwood

[Melvin- Admin]

As a Norwood 6/7 with diffuse hair loss. I’ll be straight up, you’re gonna need more than just one surgery over your lifetime. In the short term, id say 2 surgeries to address the crown, midscalp, and lateral humps. I think regardless of who you would’ve gone to, you would’ve required multiple HTs.

I don’t necessarily agree with the old school mentality of giving a Norwood 6/7 a huge forehead. My first surgery was exactly this, the surgeon gave me a transplant behind my existing hairline. It looked awful. At the time, I thought it was a good approach, but leaving a thin patch of hairs in front of the transplant looked trash.

Unfortunately, as a patient you have to pick and choose. Do the hairline first, but the crown and midscalp will still be bald. Do the crown and midscalp, the hairline will be bald. Regardless of the situation, there’s no scenario where you don’t have a patch of baldness. It’s impossible to transplant everything all at once. I’m 4 surgeries deep and I could still use more hair.

Unfortunately, it looks like you were a bit in denial with the reality of your situation. Now, you could say the clinic should have told you, but it looks like they initially did but you retorted that you had hair there and sent a picture in favorable lighting. I think they shouldn’t have tried to please you so much. Regardless of where you go, it will be 2 surgeries minimum. 

It will be a difficult case, but I can’t imagine it will be more difficult than @Gatsby I don’t think you’re donor is exhausted, your beard looks good as well.

[MazAB]

@GeneralNorwood, how did the conversation go with Dr Das? Knowing that you would've needed at least a couple of procedures anyway, do you think you'll give them a 2nd shot at it? My feeling here is that if your survival rate was good, but the plan wasn't, then formulating a clear and decisive plan before you even travel out to India, would put you in the best position to succeed overall.

I don't believe I've ever seen a patient that has been to Eugenix at least twice, come out incomplete in anyway.

You need to make the best decision for yourself, but it wouldn't surprise me at all if Dr Das and Eugenix doesn't give you the utmost of attention to every last detail for planning and executing your 2nd procedure. 

Follow my Journey with Eugenix and Dr Arika Bansal!

[Gatsby]

I always recommend that young guys err on the side of caution and 'expect' to end up a Norwood 6/7 in mind and plan accordingly from the start. That way you will always have some grafts in the bank because over the lifespan MPB is progressive and will continue so you can plan accordingly. This should be where you first start your plan. The myth that people won't care about their hair at 40, 50 is exactly that. A myth. I could have left off after my first surgery and been very happy just by the mere fact that I have coverage but no one and done surgery is perfect. Dr Sethi has made an excellent video that no hair transplant is perfect on YouTube. I went for a second surgery because I was deemed to be a candidate for a second surgery to tweak the weak points. I spent two years in weekly discussion with Dr Sethi before I pulled the first pin. But even then I was aware that things could easily have gone pear shaped but I had accepted that. Communication is key and if you and your surgeon are on the same page with goals, potential risks and barriers then going forward will leave you in a better place in the long run. All the best!

[GeneralNorwood]

10 hours ago, Melvin- Moderator said:

As a Norwood 6/7 with diffuse hair loss. I’ll be straight up, you’re gonna need more than just one surgery over your lifetime. In the short term, id say 2 surgeries to address the crown, midscalp, and lateral humps.

It is little to late to being this "straight up". Now i know that i will need multiple surgeries and i need them sooner then later. 

The thing is, if we didn't push so hard in the front and focused more on the midscalp and crown like u suggested in earlier posts, i would have natural result and wouldn't be forced to do next surgeries and use all of my donor so soon. 

If i knew that this "plan" requires 2 more surgeries so soon, i could decline it and either abandon HT at all or do conservative approach. 

But now i am dragged in this multiple surgeries world. 

10 hours ago, Melvin- Moderator said:

I don’t necessarily agree with the old school mentality of giving a Norwood 6/7 a huge forehead. My first surgery was exactly this, the surgeon gave me a transplant behind my existing hairline. It looked awful. At the time, I thought it was a good approach, but leaving a thin patch of hairs in front of the transplant looked trash.

 

Dr Bisanga said that best approach was to do  the hairline exactly at the level of existing one, and reinforce existing one. So it wouldn't look awful. And anyway, my favourite hairstyle was always combing it forward, so bigger forehead wouldn't be problem anyway. 

BTW, do you think i am Norwood 6/7 level? 

 

10 hours ago, Melvin- Moderator said:

 

Unfortunately, as a patient you have to pick and choose. Do the hairline first, but the crown and midscalp will still be bald. Do the crown and midscalp, the hairline will be bald. Regardless of the situation, there’s no scenario where you don’t have a patch of baldness. It’s impossible to transplant everything all at once. I’m 4 surgeries deep and I could still use more hair.

We could do front(2 cm higher), lateral humps, midscalp and crown and maybe there would be still some patches, but not so obvious one like now. Now i have huge disconnection between front and back. 

 

10 hours ago, Melvin- Moderator said:

Unfortunately, it looks like you were a bit in denial with the reality of your situation. Now, you could say the clinic should have told you, but it looks like they initially did but you retorted that you had hair there and sent a picture in favorable lighting. I think they shouldn’t have tried to please you so much. Regardless of where you go, it will be 2 surgeries minimum. 

Exactly this. I was in denial and my knowledge about my state of baldness was so poor. Clinic shouldn't listen so much to the client, because clients usually are not properly educated in the subject of HTs. And in Eugenix videos they tell too that if patient wants for example flared frontotemporal angle, they have to educate patient that this is not right approach. As a patient you put your trust in doctor, and you assume that doctor knows what he is doing. 

 

10 hours ago, Melvin- Moderator said:

 

It will be a difficult case, but I can’t imagine it will be more difficult than @Gatsby I don’t think you’re donor is exhausted, your beard looks good as well.

Thank you Melvin for your answer. I know that now it is difficult case and that's why i am worried. I can comfort myself, that things could've been worse. For example i could have depleted donor with 0 grafts in the bank. Fortunately, it is not the issue and i have some grafts to work with. About beard, i like growing beard and for sure i dont want to deplete it. Dr Bisanga also mentioned that structure of my beard is not so good for HT, but i don't know exactly what he meant. 

Edited March 23, 2023 by GeneralNorwood

[Rafael Manelli]

Beard is never anyone's first choice but desperate times call for desperate measures. It can be used in a pinch. Might be worth looking into. 

[GeneralNorwood]

6 hours ago, MazAB said:

@GeneralNorwood, how did the conversation go with Dr Das? Knowing that you would've needed at least a couple of procedures anyway, do you think you'll give them a 2nd shot at it? My feeling here is that if your survival rate was good, but the plan wasn't, then formulating a clear and decisive plan before you even travel out to India, would put you in the best position to succeed overall.

We didn't talk yet, I have scheduled converstation talk with Eugenix for today.

Would it be smart to go for a 2nd shot with Dr Das looking at the final result? I don't think so 😂

Clearly, now i have to make solid HT plan before traveling to any clinic for HT. 

6 hours ago, MazAB said:

I don't believe I've ever seen a patient that has been to Eugenix at least twice, come out incomplete in anyway.

I never saw a patient like me too, who had so big dissconection( whith white patches)between front and back after one procedure. 

 

6 hours ago, MazAB said:

 

You need to make the best decision for yourself, but it wouldn't surprise me at all if Dr Das and Eugenix doesn't give you the utmost of attention to every last detail for planning and executing your 2nd procedure. 

 

It wouldn't surprise you? Is that correct? 😆

[GeneralNorwood]

5 hours ago, Gatsby said:

I always recommend that young guys err on the side of caution and 'expect' to end up a Norwood 6/7 in mind and plan accordingly from the start. That way you will always have some grafts in the bank because over the lifespan MPB is progressive and will continue so you can plan accordingly. This should be where you first start your plan. The myth that people won't care about their hair at 40, 50 is exactly that. A myth.

Exactly. But now it is too late for such smart and responsible approach 😥

5 hours ago, Gatsby said:

 I could have left off after my first surgery and been very happy just by the mere fact that I have coverage but no one and done surgery is perfect. Dr Sethi has made an excellent video that no hair transplant is perfect on YouTube

My HT was far from perfect 😆

 

6 hours ago, Gatsby said:

I spent two years in weekly discussion with Dr Sethi before I pulled the first pin. But even then I was aware that things could easily have gone pear shaped but I had accepted that. Communication is key and if you and your surgeon are on the same page with goals, potential risks and barriers then going forward will leave you in a better place in the long run. All the best!

That is good thought. Now i have to take my time with planning and make sure that communication with a surgeon is great and we are on the same page. 

[GeneralNorwood]

24 minutes ago, Rafael Manelli said:

Beard is never anyone's first choice but desperate times call for desperate measures. It can be used in a pinch. Might be worth looking into. 

It was used in a pinch during my first procedure. The one thing i didn't mention in this topic yet, is that i had transplanted 32 beard grafts on my scar at the back. Just take a look at this pictures : 

 

 

 

 

Edited March 23, 2023 by GeneralNorwood

[hairman22]

Too many excuses for Eugenix here.

They are the experts. If the patient is unsure of his hairloss progression it is the job of the experts to inform him of this. And the best long term plan.

-wasting nearly 800 grafts on the temple peaks on someone who will be NW7 is crazy. Eugenix really go so aggresive on these, Now they look very good but only available to certain patients who have the donor reserves.

- The growth was great. But someone with his favourable skin to hair contract should have received less grafts resulting in a lighter coloured hair on top. 

-This would have saved scalp grafts to cover the whole scalp to some degree,

- The frontal third has a density that will be much more dense than the rest of his scalp.

 

[Eugenix Hair Sciences]

Dear @GeneralNorwood, 

We wanted to reach out to you and thank you for taking the time to participate in a video consultation with our doctors. We hope that the information and advice provided during the consultation were helpful and informative.

Please be assured that Eugenix Hair Sciences is with you every step of the way. If you have any concerns or questions, please do not hesitate to reach out to us. We are always here to support you and provide you with the best possible care.

Regards, 
Eugenix Hair Sciences 

[Delta Bravo]

Fron looks amazing, may be give meds another 5-6 months and plan carefully for the next sitting for humps, and mid. 

Eugenix is really good with their post-procedure care. 

[Berba11]

2 hours ago, GeneralNorwood said:

could do front(2 cm higher), lateral humps, midscalp and crown and maybe there would be still some patches, but not so obvious one like now. Now i have huge disconnection between front and back. 

The height of the hairline wouldn’t alter the disconnection. If you’d had a more conservative hair transplant but didn’t address the weaker areas behind, you’d still have a disconnection. 
 

If this wasn’t explained to you then that’s certainly unfortunate, but the situation hasn’t really changed. Either you needed to have a much bigger first op, or do it over two steps. You’ve been around long enough to know that HT’s are rarely and a ‘one and done’ process. 
 

Maybe trying to do it in one pass would have been preferable but you are where you are. You’ve had an otherwise very excellent looking frontal third procedure. 
 

You do have options to try and get a better blend by playing around with the length, style and hair products. Even the very best HT’s require maintenance to varying degrees. 
 

You seemed very happy with things until you met Dr Bisanga. 
 

You have plenty of good options moving forward, and if you can stabilise the existing hair and address the weak spots you’ll be golden. 

[BaldingEagle1]

So sorry you going through this @GeneralNorwood, I do hope you find a good solution and that it requires less surgeries for you to be satisfied. Whether its a 2nd do at Eugenix or Bisango (or elsewhere)!

Wishing you the best!

[Z--]

How did the call go? Would be interesting to get your perspective.

 

[Melvin- Admin]

4 hours ago, GeneralNorwood said:

It is little to late to being this "straight up". Now i know that i will need multiple surgeries and i need them sooner then later. 

The thing is, if we didn't push so hard in the front and focused more on the midscalp and crown like u suggested in earlier posts, i would have natural result and wouldn't be forced to do next surgeries and use all of my donor so soon. 

If i knew that this "plan" requires 2 more surgeries so soon, i could decline it and either abandon HT at all or do conservative approach. 

But now i am dragged in this multiple surgeries world. 

Dr Bisanga said that best approach was to do  the hairline exactly at the level of existing one, and reinforce existing one. So it wouldn't look awful. And anyway, my favourite hairstyle was always combing it forward, so bigger forehead wouldn't be problem anyway. 

BTW, do you think i am Norwood 6/7 level? 

 

We could do front(2 cm higher), lateral humps, midscalp and crown and maybe there would be still some patches, but not so obvious one like now. Now i have huge disconnection between front and back. 

 

Exactly this. I was in denial and my knowledge about my state of baldness was so poor. Clinic shouldn't listen so much to the client, because clients usually are not properly educated in the subject of HTs. And in Eugenix videos they tell too that if patient wants for example flared frontotemporal angle, they have to educate patient that this is not right approach. As a patient you put your trust in doctor, and you assume that doctor knows what he is doing. 

 

Thank you Melvin for your answer. I know that now it is difficult case and that's why i am worried. I can comfort myself, that things could've been worse. For example i could have depleted donor with 0 grafts in the bank. Fortunately, it is not the issue and i have some grafts to work with. About beard, i like growing beard and for sure i dont want to deplete it. Dr Bisanga also mentioned that structure of my beard is not so good for HT, but i don't know exactly what he meant. 

It’s hard to imagine you didn’t think you would need more than one surgery, given your hair loss pattern. I am sorry to be blunt, but I think it’s necessary. 

I don’t know what your goals or objectives were in the beginning. I would’ve preferred a more conservative approach, but that’s my personal preference. Now, I don’t agree that you would’ve somehow avoided needing another surgery. Regardless, believe me you would need a second surgery right away. 

Anyway I look at it, you would’ve needed a second surgery, even if you avoided the temples, brought up the hairline. There is no scenario where you don’t need a second surgery right away. Again, sorry to be so blunt. 

You are 1000% a Norwood 6/7. I would say you’re headed towards a Norwood 7 pattern.

There would still be patches, and believe me it would be obvious to you and everyone here. You could disguise it with fibers, but you can also do that now. 

Now that I agree, the clinic probably tried to please you too much. At no time should a patient dictate what to do or how to execute the plan. The patient should come with objectives and goals, but that’s where it ends. They shouldn’t be telling surgeons what to do. That’s a mistake accepting that.

You’re difficult no doubt, but I was 10x more difficult and I got 4,000 grafts out. I think you still have a decent donor, the blonde hair and light skin is an excellent combo. I have dark hair light skin, worst combination. 

[Bandit90]

Looking back at your thread, I do feel at your first sitting there was possibly a bit of hope that the meds would rescue the tonne of miniaturised hair you have. I can see the doctors logic by not wanting to implant in area where there is lots of miniaturised hair and risk permanent shock loss. I don't think it looks as bad as you think. Now that you have given yourself a year on dut and there has been no improvement to the miniaturised hair, I think now you can now formulate a solid plan and work on the basis it wont recover. 

Though I have a huge respect for Dr Bisanga, I personally don't agree with some his sentiments i.e about your temple looking unnatural (I think it looks really natural). Also him wanting to do a video on you titled "how not to make  HT in Caucasian male".  To me there feels an air of trying to do one over a competitor clinic here, a very extreme/unnecessary tactic, when in reality your result is only at pass one out of two passes . 

Looking at your hair characteristics they are close to mine, beard included. I honest think that adding your remaining scalp grafts with 2500 beard you will honestly look great. I know you didn't factor in a two stage plan (or was led to believe you would need one), but I think you goals will be met. 

 

 

Edited March 23, 2023 by Bandit90

[DHT]

23 minutes ago, Bandit90 said:

Looking back at your thread, I do feel at your first sitting there was possibly a bit of hope that the meds would rescue the tonne of miniaturised hair you have. I can see the doctors logic by not wanting to implant in area where there is lots of miniaturised hair and risk permanent shock loss. I don't think it looks as bad as you think. Now that you have given yourself a year on dut and there has been no improvement to the miniaturised hair, I think now you can now formulate a solid plan and work on the basis it wont recover. 

Though I have a huge respect for Dr Bisanga, I personally don't agree with some his sentiments i.e about your temple looking unnatural (I think it looks really natural). Also him wanting to do a video on you titled "how not to make  HT in Caucasian male".  To me there feels an air of trying to do one over a competitor clinic here, a very extreme/unnecessary tactic, when in reality your result is only at pass one out of two passes . 

Looking at your hair characteristics they are close to mine, beard included. I honest think that adding your remaining scalp grafts with 2500 beard you will honestly look great. I know you didn't factor in a two stage plan (or was led to believe you would need one), but I think you goals will be met. 

 

 

100%. 

 

Dr. Bisanga is a good doc, but he has not seen you a year prior, may be according to him it was aggressive but to me it looks perfect. around 6-6.5cm from glabella may be?
You just need one more sitting to get the best for you! Again, other clinic may use this as a tactics as John said but your thread is a good example of diffuse thinning and further progression of baldness and Eugenix did a great job. Good luck @GeneralNorwood, keep us posted on your progress. 

[Berba11]

I certainly agree with @Bandit90that some of Bisanga’s remarks seem a little inappropriate and not particularly sensitive, especially if he said you were an example of “how not to do a HT”. That’s not cool at all really. 

[GeneralNorwood]

4 hours ago, Berba11 said:

The height of the hairline wouldn’t alter the disconnection. If you’d had a more conservative hair transplant but didn’t address the weaker areas behind, you’d still have a disconnection. 

Berba, that's what i meant. Instead of lowering hairline,

 

4 hours ago, Berba11 said:

If this wasn’t explained to you then that’s certainly unfortunate, but the situation hasn’t really changed. Either you needed to have a much bigger first op, or do it over two steps. You’ve been around long enough to know that HT’s are rarely and a ‘one and done’ process. 

Of course situation changed, because half of the donor was used on the front. 

 

4 hours ago, Berba11 said:

You seemed very happy with things until you met Dr Bisanga. 

It wasn't like that. For sure, i didn't like the disconnected look between front and back. Reinforced by forum members, i had hopes that it will be repaired during 2nd pass. Consultation with Dr Bisanga gave me new perspective and emphasized how diffucult my case has become. 

[Berba11]

5 minutes ago, GeneralNorwood said:

 

 

6 minutes ago, GeneralNorwood said:

Consultation with Dr Bisanga gave me new perspective and emphasized how diffucult my case has become. 

What Dr Bisanga considers a difficult case and what other Dr's like Dr Pradeep consider difficult aren't going to be the same thing. There aren't many cases around more difficult than Gatsby or IrishWarrior's. Their starting positions were far, far worse than yours - higher norwoods than you are currently, much worse donor areas, extensive strip scarring and no/minimal native hair up top to cling onto with finasteride or dutasteride. Your first surgery has been a success, which makes a massive difference going forwards. And as a last resort, hairlines can go back up again if you really, really needed the grafts, but you're long way off needing to consider that.

[GeneralNorwood]

2 hours ago, Melvin- Moderator said:

It’s hard to imagine you didn’t think you would need more than one surgery, given your hair loss pattern. I am sorry to be blunt, but I think it’s necessary. 

 

I didn't think i will need second one right after first one. I know it's necessary, now it's obvious. 

 

2 hours ago, Melvin- Moderator said:

I don’t know what your goals or objectives were in the beginning. I would’ve preferred a more conservative approach, but that’s my personal preference. Now, I don’t agree that you would’ve somehow avoided needing another surgery. Regardless, believe me you would need a second surgery right away. 

If we did hairline on the level of native hair, and treated lateral humps and midscalp, result would be more blend, so there wouldn't be such pressure for 2nd pass IMO. 

 

2 hours ago, Melvin- Moderator said:

 

Anyway I look at it, you would’ve needed a second surgery, even if you avoided the temples, brought up the hairline. There is no scenario where you don’t need a second surgery right away. Again, sorry to be so blunt. 

No temples, hairline on the level of native har, doing midscalp, humps and crown. How about this scenario? 

 

2 hours ago, Melvin- Moderator said:

 

You are 1000% a Norwood 6/7. I would say you’re headed towards a Norwood 7 pattern.

 

True. On video call Hariom told me that Eugenix graded me 3V because i had a lot of hair on scalp and Norwood scale doesn't take into account diffusse thinning. 

I must say that i don't agree with this argument. You can't grade someone Nw1 because he has 100 hair all over around the scalp. If hair are miniaturised and with low density they shouldn't lower your NW grade. 

Just look at this example. THs patient has hair all over the scalp, but Dr Pinto graded him Norwood 5a : 

 

 

The pont is. If i knew that im NW6, i would think twice before going with such aggressive hairline. 

2 hours ago, Melvin- Moderator said:

 

Now that I agree, the clinic probably tried to please you too much. At no time should a patient dictate what to do or how to execute the plan. The patient should come with objectives and goals, but that’s where it ends. They shouldn’t be telling surgeons what to do. That’s a mistake accepting that.

 

 

True. Even during today's group video conference, when Amandeep told me that if i want to improve lateral humps, they can do that, i explained to him that Eugenix can't listen so much what i want, because i can be wrong about the approach and all i want is natural look, which i clearly i don't have now.  

Edited March 23, 2023 by GeneralNorwood